Organization
FAMILY HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNITA BELL A.P.N. (OWNER)
(618) 665-4612
Entity
Organization
Contact information
Practice address
134 S. CHURCH ST., LOUISVILLE, IL 62858
(618) 665-4612
(618) 665-4610
Mailing address
134 S. CHURCH ST., LOUISVILLE, IL 62858
(618) 665-4612
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
742975504001
—
IL
Enumeration date
02/09/2007
Last updated
09/13/2007
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